A Weighty Protocol Change

04/01/2013 – Andrew, Illinois

Calling the move “A necessary step in the obfuscation of Medical Direction” Dr. Herbert Franzen of the Andrew Clinic EMS system laid out sweeping protocol changes for the EMTs and Paramedics under his medical control.

“I believe that all medication doses should be weight-based.” Says the physician, who wears a calculator watch circa 1985 rather than carrying a smart-phone. “Weight-based medication dosages allow for precise administration of medications to the broadest range of patients in an emergency setting. No longer will we just make blanket statements that call for giving, say, 25 to 50mg of diphenhydramine to patients in anaphylaxis. Now, paramedics will simply administer 0.252345 mg per kg in an emergency, making the dose all the more accurate every time.”

Several of the paramedics working for ambulance services within Dr. Franzen’s EMS system have started picking up math classes at the local community college in order to sharpen their arithmetic skills which are needed to comply with the new protocols. Paramedic Mark Hansen explains:

“I work in the system part-time and work full time under another set of protocols. At my other service, we follow ACLS guidelines and administer 1mg of 1:10,000 epinephrine every 3-5 minutes in a cardiac arrest. Now, according to Dr. Franzen we need to mix up a drip of 1:1000 epi in a bag of 250ml D5W and then administer 1.734mcg per kg per minute. It gives me a headache just thinking about it.”

Even common medication dosages like Zofran (ondansetron) are being changed. Commonly, the anti-nausea drug is given in handy 4mg increments which make dosing a patient easy and quick. Under Dr. Franzen’s system, however, the medication is given at 0.346 mg per kg to increase accuracy. Seizure patients will receive 0.452mg/kg of valium if they are under the age 34.2, 0.431mg/kg if they are age 34.2 to 47.6, and 0.344mg/kg if it’s before the vernal equinox.

“My protocols are enforced by a very proactive team of Quality Assurance personnel which make sure that the medics adhere to a very strict interpretation of the rules. Variances in protocol use will not be tolerated” Dr. Franzen said. He added with a laugh “I prescribe some pretty intense ‘reeducation’ for violations.”

At press time, we received a statement from “Gorgonz the Magnificent” from the Sleeter County, IL county fair who stated that with his experience in guessing people’s weights he is considering a career move to EMS. 

  • In the interest of full disclosure, Dr. Franzen and his associates are heavily invested in my latest invention which measures the creaking of a standard Stryker MX-Pro and converts it into an approximate patient weight accurate to 41/100 of an ounce. Conversion to metric measurement remains the responsibility of the EMS provider.